Provider Demographics
NPI:1184812109
Name:JEFFCOTT, ANNE L (CRNP)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:L
Last Name:JEFFCOTT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:L
Other - Last Name:JEFFCOTT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNP
Mailing Address - Street 1:308 WOODVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-9722
Mailing Address - Country:US
Mailing Address - Phone:740-851-6120
Mailing Address - Fax:
Practice Address - Street 1:681 E 3RD ST
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:OH
Practice Address - Zip Code:45690-1572
Practice Address - Country:US
Practice Address - Phone:740-947-3010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH260798363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0160156 00Medicare UPIN